Two central activities of this effort are to define standards of quality health services for adolescents and to develop, implement and monitor activities to strengthen and reorient health systems to improve quality and expand coverage in a phased manner. The standards-driven quality improvement methods developed draw from those developed first by JHPIEGO/Quality Assurance Project.

WHO developed the “4-S Framework” for strengthening the health sector’s response to adolescent health needs. The framework uses two programmatic entry points : HIV prevention, care and support for those living with HIV; and preventing early pregnancy and pregnancy-related mortality and morbidity. Through these two entry points the framework can be used to address other public health issues affecting adolescents such as nutrition, mental health, substance use and violence. The four S’s of the strategy stand for:

Gathering and using strategic information

Developing supportive evidence-informed policies

Scaling up the provision of health services and commodities

Strengthening other sectors

Within each of these areas, the team has developed tools and identified actions required at the national, district and local levels of the health system, to improve the health of adolescents.

In order to proceed systematically, the MCA team has outlined a process for scaling up quality health service provision. The process model appears below. Each step has associated actions and tools to support their implementation.

Click on the above figure to read more about each step and to access links to relevant available tools. Note that some tools are under development. This generic step-by-step process has been drawn from the ExpandNet nine step approach to scaling up strategy development.

The MCA team has provided technical support to several countries, where the Ministries of Health work in partnership with key NGOs, and other relevant organizations to develop and implement strategies to improve adolescent health.

MCA documented a series of case studies on country initiatives that used standards driven quality improvement. Currently, further experiences gained in applying the systematic process in India, Tanzania and Moldova have been documented as papers for submission to peer reviewed journals.

For further information, contact the Department of Maternal, Newborn, Child and Adolescent Health at: mca@who.int.

Selected bibliography of products by WHO/Child and Adolescent Health Team: